Antipsychotic drug therapy accounts for 1% to 4% of the total costs involved in managing patients with schizophrenia. The greatest direct and indirect costs associated include hospitalization, rehabilitation, visits to physicians, outpatient and community support programs, lost work productivity of the individual and family members, and suicide. Successful drug therapy can significantly alter the use of direct cost services and limit the impact on indirect costs. Thus, to evaluate properly from a societal perspective, economic evaluation studies determining the cost of antipsychotics (eg, cost effectiveness analysis) are required. birth control pills
Of the new agents, clozapine and risperidone have undergone formal economic evaluations. Clozapine has been shown to be cost effective in several investigations using various methodologies, including one double-blind randomized trial. These trials were conducted in the United States, the United Kingdom and Canada and only reflect its use in patients resistant to or intolerant of conventional antipsychotics. The Canadian results were based on the clinical results of clozapine versus chlorpromazine and haloperidol in three randomized, controlled trials using a derived cost model. Similarly, risperidone has been evaluated using various methodologies; however, no prospective, randomized double-blind economic trials have been conducted. These studies indicate that risperidone can reduce costs by decreasing both time spent in hospital and the relapse rate compared with conventional treatment. Using the same approach for the evaluation of clozapine, the Canadian assessment concluded that risperidone was cost effective for nontreatment-refractory patients with chronic schizophrenia.